摘要
目的 分析加速康复外科(ERAS)对结直肠癌(CRC)患者腹腔镜根治术后炎性反应及免疫功能的影响。方法于2016年1月至2019年1月,采用随机数字表法将62例于该院行腹腔镜根治术的CRC患者分为给予ERAS措施的ERAS组(32例)和给予传统围手术期处理的对照组(30例)。于术前1d和术后3、7、14d检测外周血白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、CD4^+淋巴细胞、CD8^+淋巴细胞、淋巴细胞、单核细胞水平,计算CD4^+淋巴细胞/CD8^+淋巴细胞比值(CD4^+/CD8^+)和淋巴细胞/单核细胞比值(LMR)。结果 术后3d,所有患者IL-6、TNF-α、CRP水平较术前1d升高(P<0.05),且对照组高于ERAS组(P<0.05)。术后3d,所有患者CD4^+淋巴细胞水平较术前1d降低(P<0.05),ERAS组在术后7d恢复至术前水平(P>0.05),对照组仍低于术前水平(P<0.05);CD8^+淋巴细胞水平及CD4^+/CD8^+无明显变化(P>0.05)。术后3d,所有患者LMR水平均较术前降低(P<0.05),ERAS组术后3、7d较对照组升高(P<0.05),术后14d组间比较差异无统计学意义(P>0.05)。结论 ERAS应用于腹腔镜根治术CRC患者,有助于促进免疫功能的恢复,减轻炎性反应,有利于患者术后康复。
Objective To observe the effect of enhanced recovery after surgery(ERAS)on inflammatory response and immune function of colorectal cancer(CRC)patients after laparoscopic operation.Methods From Jan.2016 to Jan.2019,62 CRC patients,receiving laparoscopic operation in this hospital,were selected and divided into control group(30 cases),receiving traditional perioperative treatment,and ERAS group(32 cases),receiving ERAS treatment.Levels of C-reaction protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),CD4^+lymphocytes,CD8^+lymphocytes,lymphocytes and monocytes were detected on 1 day before operation,and 3,7,14 days after operation.Ratios of CD4^+ cells to CD8^+ cells(CD4^+/CD8^+)and lymphocytes to monocytes(LMR)were calculated.Results Compared to 1 day before operation,IL-6,TNF-αand CRP increased on 3 days after operation in both groups(P<0.05),and those of control group were significantly higher than ERAS group(P<0.05).Three days after operation,levels of CD4^+ cells were significantly decreased in both groups,compared with 1 day before operation(P<0.05).Seven days after operation,there was no significant differences of CD4^+ cells in ERAS group,compared with 1 day before operation(P>0.05),but there was significant difference in control group(P<0.05).There were no changes of CD8+cells and CD4^+/CD8^+.Three days after operation,LMR was decreased,compared with 1 day before operation in both groups(P<0.05).On the 3 and 7 days after operation,LMR in ERAS group were higher than control group(P<0.05).There were no significant differences in LMR between control group and ERAS group on the 14 days after operation(P>0.05).Conclusion Application of ERAS in CRC patients,receiving laparoscopic operation could be beneficial to protect the patient′s immune function and reduce inflammation.
作者
李振想
姜孝奎
武文杰
李韶山
LI Zhenxiang;JIANG Xiaokui;WU Wenjie;LI Shaoshan(Department of General Surgical,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang,Henan 453003,China)
出处
《现代医药卫生》
2020年第8期1159-1161,1164,共4页
Journal of Modern Medicine & Health
关键词
加速康复外科
结直肠癌
免疫功能
炎性反应
Enhanced recovery after surgery
Colorectal cancer
Immune function
Inflammation
作者简介
李振想(1983-),硕士研究生,主治医师,主要从事结直肠肿瘤相关研究;通信作者:武文杰 ,E-mail:xiaogouzi1983@163.com。
